HIV rate is rising among women

April 11, 2007|DAVID RUMBACH Tribune Staff Writer

SOUTH BEND -- When it comes to HIV transmission, love is not a two-way street. For a variety of biological reasons, men are much more likely to infect women with HIV than women are likely to infect men, according to South Bend family physician Dr. Brandon Zabukovic. It's one of the reasons the infection rate is growing fastest among women and why women now account for more than a quarter of new infections. "Women are catching up with men," he said. Zabukovic spoke last week at the 14th annual Women & AIDS Conference at Ivy Tech State College. A family physician at Memorial Hospital's central neighborhood clinic, Zabukovic is currently caring for about 120 patients with HIV or AIDS in his practice. The conference, sponsored by AIDS Ministries/AIDS Assist, focused on ways that women can protect themselves from HIV infection, especially in the black community where it is far more prevalent than in other ethnic groups. Although AIDS is historically associated with homosexual activity and drug use, it's a disease of heterosexual activity for women, according to the Centers for Disease Control and Prevention. The CDC reports that more than 80,000 black women were living with HIV or AIDS at the end of 2005, compared with only about 24,000 white women and about 19,000 Hispanic women. A large majority of black women, nearly 75 percent, catch AIDS through high-risk heterosexual contact, with about one-fourth being infected through intravenous drug use. Elizabeth Mooney, an adjunct lecturer in sociology at Indiana University South Bend, said men in the local black and Hispanic community are not being upfront about their sexual activity and HIV status, putting their partners at risk. Mooney, a longtime teacher and therapist in the area of human sexuality, said the danger involves men who have had sex with other men, although their sexual identity is heterosexual. Because they're afraid of being labeled gay, they're not being tested for HIV. Or if they have been tested positive, they're hiding the fact from their wives or girlfriends, sometimes with the complicity of their doctors, Mooney said. The practice of men having sex on the side with other males is known well enough in the black community to have its own slang term: sex on the down low. "We have a severe problem in the black and Latino communities," Mooney said. "They're bringing HIV home to their wives, and now we have a whole bunch of women who are HIV positive and don't have a clue how they got that way." Mooney said even though the phenomenon of "down low" exposure to HIV is well-known, black women who are married or in stable relationships seem to be reluctant to be tested. "Their concept is, 'if I don't know about it, it won't hurt me,'" she said. Untreated HIV infection, however, eventually leads to impairment of the immune system and the emergence of opportunistic infections and diseases. Zabukovic said the most common initial manifestations of the virus are recurrent candida vaginosis, enlarged lymph nodes and bacterial pneumonia. Other common opportunistic diseases seen in women include shingles, menstrual irregularities, cervical cancer, bacterial vaginosis and pelvic inflammatory disease. Zabukovic said it may be time for physicians to consider underlying HIV in older patients when they see those diseases. "Maybe it should be on our radar," he said. Zabukovic said a handful of local physicians are caring for most of the HIV-positive people in St. Joseph County. "We're all pretty tapped out," he said. "We could use some help." Staff writer David Rumbach: drumbach@sbtinfo.com (574) 235-6358